Susan's Place Transgender Resources

I've been on estradiol valerate IM for 6 weeks today (and spironolactone for 9 weeks). My first labs came back and my testosterone level is within range (16ng/dl), but my estradiol is high (366pg/ml) so my provider more than halved my initial dose !!

While I know that these ranges are based on current medical guidelines, I just feel a bit upset. I thought I was going to be titrated up, at least that's what my provider said the last time I saw them, but I'm being titrated down instead.

Has anyone else experienced this? Is it really possible for a low dose to keep you within female range for estradiol?

Side note: if this violates the rules of the forum, please feel free to delete.


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It's the long term exposure to estradiol in the normal female range that works the magic. You don't need or want excess chemicals in your body. Sit back and enjoy the ride.  :)

Hugs, Devlyn

The amount of time between your last injection and the blood draw will determine your levels. If the draw was a day or two after your last injection, expect a high level. A blood draw just before your injection will produce a low level. Figure your level will half over a period of 6 days and you might get a feel as to why your levels are the way they are. If your blood draw was just before an injection, then a dosage reduction might be correct.

That happened to me as well early on.  I was injecting weekly....at a full dose and my levels were 1889pg\ml.  She asked me to half my dose. i listened

The levels you are at are in the feminine range. I last tested at 45 pg/ml (note: I am on a once a day pill) and my body is developing. Just so you can see what normal levels are, I am including a table that may help.


ESTRADIOL LEVELS
SEX                     pg/ml
Women (> 18 years old)   
      Follicular Phase  30-120
      Ovulatory Peak   130-370
      Luteal Phase      70-250
      Post-Menopausal   15-60
Male                    15-60

TOTAL TESTOSTERONE LEVELS
SEX      ng/dl        ng/ml
Females  6 - 86     0.1 - 1.2
Males  270 - 1100   2.4 - 12
Conversion factor: 1 ng/ml = 3.47 nmol/l


https://www.questdiagnostics.com/dms/Documents/test-center/si_units.pdf

Analyte        Gravietric  Conversion International
               Unit        Factor     Unit
Estrone        pg/mL       3.699      pmol/L
Estradiol      pg/ml       3.67       pmol/L
Estriol        pg/ml       3.47       nmol/L

The important thing, IMHO, is that your development is going well and you are feeling good.

My doctors (an endocrinologist with extensive experience with transsexuals and a general practitioner who wrote a book on female hormones) are comfortable with higher levels (I've had as high as 4,000 pg/ml on injections) and deemed it was safe based on blood test results and my response. To each their own.

In women, levels fluctuate a lot. During a menstrual cycle, depending on the lab's range and the woman, levels can be anywhere from 20 to up to 760 pg/ml. During pregnancy, they can go as high as 75,000.

There is research to suggest those levels are fine, but they are higher than current recommendations from trans medical types. As mentioned, when the blood was drawn in relation to your injection will also play a part in the resulting level.

There is a general theory that "Levels are the most important.", which is interesting, as it ignores a large part of the reason we take HRT - mental health. It seems that some people, at "recommended" levels, continue to suffer from negative mental health effects that are alleviated at higher doses. Others seem to do just fine on a lower dose, it really is an individual thing - something the trans community doesn't really seem to get.

Quote from: Dena on January 11, 2018, 10:25:26 PM
The levels you are at are in the feminine range. I last tested at 45 pg/ml (note: I am on a once a day pill) and my body is developing. Just so you can see what normal levels are, I am including a table that may help.


ESTRADIOL LEVELS
SEX                     pg/ml
Women (> 18 years old)   
      Follicular Phase  30-120
      Ovulatory Peak   130-370
      Luteal Phase      70-250
      Post-Menopausal   15-60
Male                    15-60

TOTAL TESTOSTERONE LEVELS
SEX      ng/dl        ng/ml
Females  6 - 86     0.1 - 1.2
Males  270 - 1100   2.4 - 12
Conversion factor: 1 ng/ml = 3.47 nmol/l


https://www.questdiagnostics.com/dms/Documents/test-center/si_units.pdf

Analyte        Gravietric  Conversion International
               Unit        Factor     Unit
Estrone        pg/mL       3.699      pmol/L
Estradiol      pg/ml       3.67       pmol/L
Estriol        pg/ml       3.47       nmol/L

<Unwarranted and uncalled for remark deleted>
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